Abstract
IntroductionSurgical site infections (SSIs) following groin hernia repair (GHR) are getting rarer in high income countries despite a wider use of meshes. Among the risk factors for SSIs, those related to the mesh and the surgical technique have rarely been described.MethodsA registry-based multicenter study using prospectively collected data, including SSIs and their potential risk factors, was conducted in the French Hernia-Club.ResultsBetween 2012 and 2019, 21,976 consecutive unselected adult patients aged 64.8 ± 15.4 years old (88.9% male) underwent GHR (83.5% unilateral). Fifty four percent were laparoscopic; 97.6% used mesh. The overall incidence of SSI was 0.26%. The incidence of SSI was respectively, 0.24% and 0.19% (p = 0.420) in open vs laparoscopic repairs; 0.19% and 0.25% (p = 0.638) for polyester vs polypropylene mesh; In adjusted multivariate analysis focusing on macroporous meshes (which were the most implanted meshes: 23,148 out of 24,099), there were no differences in terms of SSIs’ rates regarding the technique: open versus laparoscopy (p = 0.762) nor the type of mesh used: polypropylene versus polyester (p = 0.557).ConclusionThe rate of SSI following GHR was low in this large registry study. Mesh type and surgical technique did not affect SSIs rates. Caution is advised when interpreting these data due to this very low rate of SSI and the potential for a type II error.
Highlights
Surgical site infections (SSIs) following groin hernia repair (GHR) are getting rarer in high income countries despite a wider use of meshes
Regardless of the association between technique used and the type of hernia operated, there was no significant difference in surgical site infections (SSIs) number (p = 0.267) After logistic regression adjusted for ASA score, bilateral hernia surgery or open surgery, none of these factors were linked to an increased risk of SSI (Table 4a)
We report an overall 0.26% rate of SSI for a cohort of 21,976 patients having undergone an elective GHR and registered in the French Hernia club registry
Summary
Surgical site infections (SSIs) following groin hernia repair (GHR) are getting rarer in high income countries despite a wider use of meshes. Among the risk factors for SSIs, those related to the mesh and the surgical technique have rarely been described. Mesh type and surgical technique did not affect SSIs rates. Groin hernia repair (GHR) is the most frequent intervention in elective general surgery. It represents around 2000 operations per million people per year in High Income Countries [1]. Among the risk factors for SSIs, those potentially related to the type of mesh and the surgical technique used have rarely been studied
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